NPIMap

Individual provider Active NPI

Alicia Marie Shoup, PT

  • Orthopedic Physical Therapist
  • Mesa, AZ
National Provider Identifier
1760865125
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
11544PT Issued in AZ
Practice address
10165 E Hampton Ave
Mesa, AZ 85209-3327
Phone
(480) 354-5424
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X DAPT000189 PA
Orthopedic Physical Therapist 2251X0800X 11544PT AZ Primary
Orthopedic Physical Therapist 2251X0800X PT007130L PA

Addresses

Primary practice location

10165 E Hampton Ave
Mesa, AZ 85209-3327

Mailing address

10165 E Hampton Ave
Mesa, AZ 85209-3327
Phone (480) 354-5424

Other names 1

  • Alicia Marie Kurtz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11544AZMDAddiction (Substance Use Disorder) Counselor
DAPT000189PAMDPhysical Therapist
11544PTAZMDOrthopedic Physical Therapist
PT007130LPAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1760865125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10165 E HAMPTON AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093327",
            "telephone_number": "480-354-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10165 E HAMPTON AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093327",
            "telephone_number": "480-354-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT000189",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "11544PT",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT007130L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "KURTZ",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.